Individual
BARBARA BOLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1114 MAIN ST, LEWISTON, ID 83501-1902
(208) 743-1974
Mailing address
535 CRESTLINE CIRCLE DR, LEWISTON, ID 83501-6704
(208) 798-0128
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
08-002391
ID
Other
Enumeration date
03/10/2011
Last updated
03/22/2011
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